PURPOSE: Implant surface modification and implant design are the principle targets for achieving successful primary stability. The aim of this study was to measure implant stability quotient (ISQ) values of sandblasted, large-grit, acid-etched (SLA) implants with tapered straight body design during the healing period, and to determine the various factors affecting implant stability. MATERIALS AND METHODS: To measure implant stability, resonance frequency analysis (RFA) was performed in 26 patients (13 women and 13 men) with 44 SLA implants with tapered straight body design. Implant stability (ISQ values) was evaluated at baseline and healing abutment connection (12 weeks), and the correlations between RFA and insertion torque (IT), bone quality, and jawbone were determined. RESULTS: The mean ISQ value of the implants was 69.4 ± 10.2 at the time of implant placement (baseline) and 81.4 ± 6.9 at the time of healing abutment connection (P < 0.05). Significant differences were found between RFA and bone quality and between RFA and jawbone (P < 0.05). No significant differences were found between RFA and IT, insertion area, fixture diameter, and implant length (P > 0.05). CONCLUSION: ISQ values of SLA implants with tapered straight body design were high at baseline and healing abutment connection. It was concluded that SLA implants with tapered straight body design show improved primary and secondary stability, and that immediate or early loading may be applicable.
Female ; Humans ; Torque

Purpose: To profile various clinical characteristics of sleep bruxism (SB) patients with idiopathic facial pain (IFP) in the orofacial region. Materials and Methods: We analyzed 28 SB patients among 210 patients with IFP complaints. The profiles were evaluated using patient charts including gender, age, pain duration, pain location, pain intensity and affected areas by pain. Results: SB with IFP occurred more often in females (85.7%) than males (14.3%). The mean age at presentation was 48.9 years. The most common IFP sites of SB patients were the right maxilla (28.6%) and the right mandible (25.0%). The pain complaints occurred mostly in 2 teeth or areas (50.0%), followed by 1 area (28.6%) and then in ≥ 3 teeth or areas (21.4%). The mean pain intensity was 5.9 on a visual analogue scale from 0 to 10. The pain was spontaneous in 20 patients (71.4%), and the mean pain duration was 24.4 months. Conclusion Identification of clinical characteristics of SB patients with IFP could be useful in the diagnosis of various IFP patients and beneficial in decreasing unnecessary care to reduce IFP. Further studies with larger number of subjects and extended duration are required for more systemized diagnostic methods and development of future treatment guidelines.

One hundred and three patients with strabismus who were undergoing extraocular muscle surgery were studied to compare the incidence of arrhythmia following the traction of ex- traocular muscles under halothane and sevoflurane anesthesia. Fifty four patients were anesthetized with O2-halothane(halothane group) and forty nine patients with O2-sevoflurane (sevoflurane group). The incidences of arrhythmia were 74.1% and 71.4% in halothane and sevoflurane group, respectively. There was no significant change of blood pressure in either group when arrhythmia occurred. The incidence of arrhythmias in female patients of the sevoflurane group was higher than that in male patients, while not in the halothane group. In the sevoflurane group, the incidence of arrhythmia followed by the traction of medial rectus muscle was significantly higher than that of lateral rectus muscle. In conclusion, there was no significant difference in the incidence of arrhythmia following the traction of extraocular muscles between halothane and sevoflurane anesthesia, and sinus bradycardia was the most common arrhythmia with either anesthetic.
Anesthesia ; Anesthetics* ; Arrhythmias, Cardiac ; Blood Pressure ; Bradycardia ; Female ; Halothane ; Humans ; Incidence ; Male ; Muscles ; Solubility* ; Strabismus ; Traction

BACKGROUND: Vitamin D plays an important role in the immune response against infection. The purpose of the present study was to investigate the influence of vitamin D deficiency on the progression of otitis media (OM) using an experimental rat model. METHODS: Four-week-old male Sprague-Dawley rats (n=72) were divided into two groups based on their diet: a control diet group (n=36) and a vitamin D-deficient diet group (n=36). After 8 weeks of diet, experimental OM was induced by inoculation of non-typeable Haemophilus influenzae in the middle ear cavity. The rats were evaluated with otomicroscopy to determine the inflammation in the middle ear mucosa on days 1, 2, 4, 7, and 14 post-inoculation. Bullae from sacrificed rats were collected and analyzed histologically. RESULTS: The middle ear mucosa from rats with vitamin D deficiency showed a significantly higher thickness than that of controls during the course of OM. The maximum mucosal thickness was 56.0±9.1 µm in the vitamin D deficiency group, and 43.9±9.8 µm in the control group, although there was no significant difference in the tympanic membrane score between the two groups evaluated with otomicroscopy. An immunohistochemical study showed increased expression of interleukin 6 (IL-6) and tumor necrosis factor α in rats manifesting vitamin D deficiency and decreased expression of IL-10 compared with controls. CONCLUSION: Our results showed that vitamin D deficiency may exacerbate the pathophysiological changes of OM via altered cytokine production. Therefore, maintaining vitamin D status in the optimal range may be beneficial for proper management of OM.
Animals ; Diet ; Ear, Middle ; Haemophilus influenzae ; Humans ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Male ; Models, Animal ; Mucous Membrane ; Otitis Media* ; Otitis* ; Rats* ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; Tympanic Membrane ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

No abstract available.
Humans* ; Leukemia*

A simple and sensitive assay method was developed for cefepime in human plasma using high performance liquid chromatography (HPLC). Cefepime and cefadroxil (the internal standard) were extracted from heparinized human plasma by simple deproteination with perchloric acid. The extract was injected into an Atlantis dC18 column (250 X 4.6 mm; particle size 5micrometer, Waters) and the column was eluted with methanol and 0.01 M dihydrogen phosphate at pH 3.0 (15 : 85 v : v) as a mobile phase at a flow rate of 0.7 mL/min. Linearity was confirmed for the range 0.25 to 200 micro L/mL and the limit of quantitation was 0.25 micro L/mL. The retention times were 10.2 min and 13.4 min for cefepime and cefadroxil, respectively. This method was successfully applied to a pharmacokinetic study of cefepime in plasma from bone marrow transplant patients.
Bone Marrow ; Cefadroxil ; Chromatography, High Pressure Liquid ; Chromatography, Liquid* ; Heparin ; Humans* ; Hydrogen-Ion Concentration ; Methanol ; Particle Size ; Plasma*

Objective: Management of heavily pre-treated platinum-resistant ovarian cancer remains a therapeutic challenge. Outcomes are poor with non-platinum, single-agent chemotherapy (CT); however, molecularly targeted anticancer therapies provide new options. Methods: This open-label, investigator-initiated, phase 2 umbrella trial (NCT03699449) enrolled patients with platinum-resistant ovarian cancer (at least 2 prior lines of CT and Eastern Cooperative Oncology Group 0/1) to receive combination therapy based on homologous recombination deficiency (HRD) and programmed death ligand 1 (PD-L1) status determined by archival tumour sample assessment. HRD-positive patients were randomised to either olaparib 200mg bid tablet + cediranib 30mg qd (arm 1) or olaparib 300mg bid tablet + durvalumab 1,500mg q4w (arm 2). HRD-negative patients were allocated to either durvalumab 1,500 mg q4w + pegylated liposomal doxorubicin (PLD) or topotecan or weekly paclitaxel (6 cycles; arm 3, those with PD-L1 expression) or durvalumab 1,500 mg q4w + tremelimumab 75mg q4w (4 doses) + PLD or topotecan or weekly paclitaxel (4 cycles; arm 4, those without PD-L1 expression). Arm 5 (durvalumab 1,500 mg q4w + tremelimumab 300mg [1 dose] + weekly paclitaxel [60 mg/m2 D1,8,15 q4w for 4 cycles] was initiated after arm 4 completed. The primary endpoint was objective response rate (ORR; Response Evaluation Criteria in Solid Tumours 1.1). Results: Between Dec 2018 and Oct 2020, 70 patients (median 57 years; median 3 prior treatment lines [range 2–10]) were treated (n=16, 14, 5, 18, and 17, respectively). Overall ORR was 37.1% (26/70, 95% confidence interval=25.9, 49.5); 2 achieved complete response. ORR was 50%, 42.9%, 20%, 33.3%, and 29.4%, respectively. Grade 3/4 treatment-related adverse events (TRAEs) were reported in 37.5%, 35.7%, 20%, 66.7%, and 35.3% of patients, respectively. No TRAEs leading to treatment discontinuation and no grade 5 TRAEs were observed. Conclusion This study, the first biomarker-driven umbrella trial in platinum-resistant recurrent ovarian cancer, suggests clinical utility with biomarker-driven targeted therapy. All treatment combinations were manageable, and without unexpected toxicities.

BACKGROUND: Neuroprotective therapy is essential in the management of Parkinson's disease(PD). As symptomatic benefit of a treatment may clinically mask the disease progression, an evaluation of the effect of a neuroprotective therapy should be based on objective measurement of in vivo dopaminergic integrity: Nuclear imaging techniques such as SPECT or PET can visualize dopaminergic system using dopamine transporter ligands and show the promise for this purpose. The objective of this study is to examine the changes of dopamine transporter in the animal model of PD and those correlations with behavioral and biochemical changes. METHODS: We injected 6-hydroxydopamine into the substantia nigra in Sprague-Dawley rats to establish the unilateral PD model, and examined the rotation response after apomorphine injection as a behavioral aspect of the animal model. And we also measured the dopamine and DOPAC level in the striata and the dopamine transporter by [3H]-mazindol autoradiography. RESULTS: We observed that the rats showed turning behavior only after severe reduction of dopamine and DOPAC. There was a strong inverse correlation between rotation behavior and striatal dopamine, DOPAC and dopamine transporter density. There was a positive and strong linear-correlation between dopamine transporter density and dopamine or DOPAC levels. CONCLUSION: Measurement of dopamine transporter gives a good estimate of striatal dopamine level in an animal model of PD. In vivo measurement of dopamine transporter will give an objective information on the integrity of presynaptic nigrostriatal dopaminergic system.
3,4-Dihydroxyphenylacetic Acid ; Animals ; Apomorphine ; Autoradiography ; Disease Progression ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Ligands ; Masks ; Models, Animal ; Oxidopamine* ; Parkinson Disease* ; Rats* ; Rats, Sprague-Dawley ; Substantia Nigra ; Tomography, Emission-Computed, Single-Photon

Retrograde transpapillary cholangioscopy can be safely performed by use of a mother-baby-scope system after endoscopic sphincterotomy. Improved endoscopes are now available and may lead to a better acceptance of this technique. Cholangioscopy is complementary to cholangiography for differential diagnosis of various types of bile duct lesions. From march 1992 to September 1994, we performed 15 cases of peroral cholangioscopy for evaluation of bile duct lesions. Indications of peroral cholangioscopy were 6 cases of benign biliary diseases and 9 cases of malignant biliary diseases. In benign diseases, two cases of extrahepatic bile duct stones, 1 case of intrahepatic duct stone with stricture, 2 cases of benign elevated lesions of bile duct and 1 case of occluded expandable metallic stent were involved. In malignant diseases, 7 cases of primary bile duct cancer, 2 cases of hepatocellular carcinoma with bile duct invasion were involved. By use of peroral cholangioscopy with biopsy, differential diagnosis of bile duct lesion was possible. As a complication, severe abdominal pain and hypotension was developed in one case during the procedure and in another case, cholangitis was developed after the procedure. In conclusion, peroral cholangioscopy is a safe and useful procedure in various types of biliary diseases especially in the differential diagnosis of malignancy.
Abdominal Pain ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Carcinoma, Hepatocellular ; Cholangiography ; Cholangitis ; Constriction, Pathologic ; Diagnosis, Differential ; Endoscopes ; Hypotension ; Sphincterotomy, Endoscopic ; Stents

BACKGROUND: Insulin resistance has been identified as one of the risk factor of atherosclerosis. Hypertension, obesity, glucose intolerance and dyslipidemia could induce atherosclerosis through mechanism of insulin resistance. And there are some reports that hyperinsulinemia itself could induce coronary artery disease(CAD). Then we planed to investigate relationship between CAD and insulin resistance. And smoking is also known as one major risk factor of CAD. So we also investigated the relationship between smoking and insulin resistance in the CAD patients. METHODS: Among 36 subjects in whom coronary angiography was done, we grouped 25 subjects who had stenotic coronary artery as a CAD group and 11 subjects without stenosis as control group. We compared insulin and glucose response to oral glucose load(75g), serum lipid concentrations, blood pressure, and degree of obesity between two groups. We also divided CAD group into smoking and nonsmoking subgroups, compared the above parameters. RESULTS: 1) There were no significant difference in body mass index, blood pressure, creatinine, cholesterol, HDL-cholesterol, between the CAD group and the control group. There were significantly higher incidence of smokers in CAD group. 2) Insulin concentration at 120 minutes after glucose load were significantly higher in the CAD group than the control group. 3) In the CAD group, fasting plasma insulin concentration insulin area, peak plasma insulin concentration and insulin concentration at 60,90,120 minutes after glucose load were significantly higher in non-smoking group. CONCLUSION: Enhanced insulin reponse such as higher insulin concentration 60 minutes after glucose load in the CAD group suggests that insulin resistance is a risk factor of CAD. And insulin response was more pronounced in the non-smoker subgroup than smoker subgroup in the CAD patients. Thus role of insulin resistance in provoking coronary artery disease is more important in the non-smoker.
Atherosclerosis ; Blood Pressure ; Body Mass Index ; Cholesterol ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Creatinine ; Dyslipidemias ; Fasting ; Glucose ; Glucose Intolerance ; Humans ; Hyperinsulinism ; Hypertension ; Incidence ; Insulin Resistance* ; Insulin* ; Obesity ; Plasma ; Risk Factors ; Smoke ; Smoking